A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

Assess for neck vein distention

Monitor for postural hypotension

Assess blood glucose level

Monitor for an irregular heart rate

Weigh the client daily

Answer and Explanation

Correct Answer : A,C,D,E

A. Assess for neck vein distention: Neck vein distention can occur in Cushing's syndrome due to fluid retention and hypertension. It is an important sign to monitor as it can indicate complications like heart failure.

B. Monitor for postural hypotension: Clients with Cushing's syndrome typically have hypertension rather than hypotension. Therefore, postural hypotension is not a common issue to monitor for in these patients.

C. Assess blood glucose level: Hyperglycemia is common in Cushing's syndrome due to increased cortisol levels, which promote glucose production and reduce glucose uptake by cells. Monitoring blood glucose is essential to manage this condition.

D. Monitor for an irregular heart rate: Cushing's syndrome can cause electrolyte imbalances (like hypokalemia), which may lead to cardiac arrhythmias, so monitoring for an irregular heart rate is important.

E. Weigh the client daily: Daily weight monitoring helps track fluid retention, which is common in Cushing's syndrome due to cortisol-induced fluid retention. This can help in managing the client’s fluid status and detecting worsening of symptoms.

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Correct Answer is A

Explanation

A. Regular insulin: Regular insulin is the preferred insulin for the treatment of diabetic ketoacidosis (DKA) because it has a rapid onset of action and can be administered intravenously. This allows for quick correction of hyperglycemia and ketoacidosis.

B. NPH insulin: NPH (Neutral Protamine Hagedorn) insulin is an intermediate-acting insulin that does not act quickly enough to be effective in the acute management of DKA. It is used for basal glycemic control and not for emergencies.

C. Insulin detemir: Insulin detemir is a long-acting insulin and is not suitable for the acute treatment of DKA. It is used for maintaining basal levels of insulin over a longer period rather than for rapid glucose control.

D. Insulin glargine: Insulin glargine is also a long-acting insulin used to provide a steady level of insulin over 24 hours and is not appropriate for acute management of DKA, which requires rapid-acting insulin.

A. Chloride 99 mEq/L B. Calcium 10 mg/dL C. Sodium 136 mEq/L D. Potassium 2.3 mEq/L

Correct Answer is D

Explanation

A. Chloride 99 mEq/L: A chloride level of 99 mEq/L is within the normal range (96-106 mEq/L) and is not typically a cause for concern. It does not indicate any significant imbalance that would require immediate attention.

B. Calcium 10 mg/dL: A calcium level of 10 mg/dL is within the normal range (8.5-10.5 mg/dL). Hydrochlorothiazide can cause hypercalcemia, but a level of 10 mg/dL is still within acceptable limits and not alarming.

C. Sodium 136 mEq/L: A sodium level of 136 mEq/L is within the normal range (135-145 mEq/L). While hydrochlorothiazide can cause electrolyte imbalances, this sodium level does not indicate hyponatremia or hypernatremia and is not a critical finding.

D. Potassium 2.3 mEq/L: A potassium level of 2.3 mEq/L is significantly below the normal range (3.5-5.0 mEq/L) and indicates severe hypokalemia. This is a critical finding that needs to be reported because low potassium levels can lead to dangerous cardiac arrhythmias and other complications.

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A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

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